While working on a medical surgical unit, I was assigned to an 82-year-old female for purposes of this paper we will call her (Mrs. M) with an admitting diagnosis of CHF, SOB, dehydration and a past medical history of dementia.
During my morning rounds I began my assessment of Mrs. M., and I noted that she had shortness of breath and she was making gurgling sounds. I immediately auscultated her lungs and noted bilateral wheezing throughout all fields, her heart was irregular and rapid and she had 2plus pitting pedal edema. I noticed she had an IV running at 125ml/hr, which I quickly stopped. The patient did not have orders for IV fluid there was only an order to KVO. I raised the head of the bed and paged respiratory to the floor.
I also called the patients primary physician and reported the situation. I informed the doctor that the respiratory team was at the patient’s bedside administering a nebulizer treatment and that the infusion was discontinued due to my findings. The patient’s primary physician arrived quickly to the floor to assess the patient. He ordered Lasix 20mg ...
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